Labour activity and occupational factors associated with kidney function deterioration among workers of the sugarcane industry in Peru

Abstract

Objective: This study compares field workers exposed to occupational conditions with non-field workers to determine the worsening of renal function (eGFR) in workers in the sugar industry.

Methods: The baseline examination occurred from September to December 2021 in Centro Poblado San Jacinto, Peru, involving 372 men aged 18-60. We compared kidney function between 219 field workers (cane cutters, seed cutters, and seeders) exposed to high heat stress and 153 non-field workers (factory and administrative) with low/no heat stress exposure. Exclusions included participants with high blood pressure, diabetes, and chronic kidney disease. We collected data on CKD risk factors, sociodemographic information, work history, and lifestyle. Measurements included height, weight, blood pressure, serum creatinine, urine analysis, and ambient temperature. The outcome was eGFR <90 ml/min/1.73 m² and heat-related symptoms.

Results: Field workers reported lower fluid intake (mean 2.7 L) during long shifts with few breaks, while non-field workers had higher rates of alcohol and tobacco use. Field workers had higher serum creatinine (mean 0.84 vs 0.70 mg/dL) and lower eGFR (mean 112 vs 105 ml/min/1.73 m², p < 0.001), especially among burned cane cutters. Field workers were twice as likely to have reduced kidney function (PR: 1.82, 95% CI: 1.00-3.34), were more frequently dehydrated, and reported more symptoms like muscular weakness, cramps, and exhaustion.

Conclusion: We found significantly lower kidney function among field workers, particularly seed and cane cutters. These findings emphasize the need for targeted interventions to protect the renal health.

Keywords: CKDu; Heat stress exposure; Occupational health; Peru; Sugarcane work; eGFR.